This proposal will create a Washington State Stroke Trials Network (WA-STN) with the University of Washington Stroke Center at Harborview (HMC) serving as the Regional Coordinating Center (UW-RCC). Dr. David Tirschwell, UW Associate Professor of Neurology, a board certified Vascular Neurologist, a recognized regional leader in stroke care and Medical Director for Comprehensive Stroke Care at Harborview, will be the PD/PI. UW investigators have been conducting NIH and industry funded stroke research, including clinical trials, for more than a decade, including SPSS, FIA, GOCHA, RESPECT, POINT, SHINE, TIPS, HI-DEF, CHS and MESA. Our UW-RCC coordinators have tremendous experience in stroke research, and are well qualified to interface with WA-STN hospitals to ensure rapid start up (facilitated by a central IRB and Master Trial Agreements) and highest quality execution of trials. The WA-STN will be comprised of 16 hospitals of varying sizes (including 2 children's hospitals and smaller hospitals that are UW TeleStroke partners), mostly in western Washington, who based on 2011 hospital data represent ~5,732 patients with stroke or TIA (17% non-Caucasian, 11% Hispanic), an adequate number and variety to meet trial enrollment goals. The UW-RCC will be organized around a core Operations Committee to facilitate rapid start-up, monitor sites and interface with the NCC/DMC/NINDS, a WA-STN Steering Committee to discuss trials and progress and share best clinical and research practices and an Advisory Committee (a diverse group of UW and STN researchers with remarkable stroke expertise) whose members are available to advise locally or nationally on basic science or clinical aspects of study design, to serve as local-Pis for trials and to serve as mentors for the stroke research fellow. WA-STN meetings and HMC monthly stroke education webcasts will be key to dissemination of network progress and results. Dr. Tirschwell is also Program Director for the HMC based ACGME Vascular Neurology fellowship, so is well suited to provide mentoring and access to a broad array of research and educational resources (many of which are available and strengthened through the UW CTSA) and expert mentors for our annual stroke research fellow.